医学英语 心脏

ThecardiovascularsystemStudent'scopySUMC

2011-2012m

What

isthecirculatorysystem?

m

What

does

the

CV

system

do?

m

Internal

and

external

anatomymCardiaccyclemHeartsoundsm

Conductivesystemofthe

heart■

Blood

vesselsmDiseasesoftheCVSThe

Heart

and

bloodvessels

together

makeupthecardiovascularSystem.m

Circulate

blood

throughout

entire

body

for□Transport

of

oxygen

to

cells□Transport

of

CO2

away

from

cells□Transport

of

nutrients(glucose)to

cells□

b

d

une

system

components□Transportofendocrineglandsecretionsemiioofit,antmenlse(celMov(a)Right

lungHeartAnterior(b)SuperiorvenacavaLeft

lung

Aortaut)Pulmonary

trunkParietal

caur

ardiumApex

ofheartDiaphragmticla(tapleurParieTheHeart:locationinthoraxMidsternal

line2nd

ribSternumDiaphragm(c)Oblique

PositionApex=Left

of

Midline(5thSuperiorRight=3rdCostalSuperiorLeft=2ndCostalCartilage,1”left

midsternumInferiorRight=6thCostalInferiorLeft=5thIntercostalTheHeart:location

inthoraxICS),Anterior

to

rest

of

heartBase(posteriorsurface)sitsonCartilage,1”right

midsternumCartilage,1”right

midsternumSpace

at

Midclavicular

linevertebral

column■■■■■mThe

Heart:muscle

layersandcoveringsCopyright

Tne

MoGraw-Hi

Companies,Inc.Permission

roquired

for

reprotuction

or

display.Serous

membranePericardialcavityParietalpericardiumFibrouspericardiumContinuous

withblood

vesselsEndocardiumMyocardiumEpicardium(visceralpericardium)Coronary

bloodEndothiliumConnectivevesseltissExternal

HeartAnatomyBrachiocephalicarterySuperiorvenacavaRight

pulmonaryarteryAscendingaortaPulmonarytrunkRightpulmonaryRight

atrium

iaorvye

eicrlAnterior

cardiac

veinRight

ventricleMarginalarterySmallcardiacveinInferiorvenacava(a)ar—ntrartatrronvgtogrniLeftcommoncarotid

artery——

Leftsubclavianartery—

Aortic

arch——

Ligamentumarteriosum-

Left

pulmonaryarteryLeftpulmonaryveinsLeftatriumAuricleCircumflexarteryLeftcoronaryarteryLeft

ventricleGreat

cardiac

veinAnteriorinterventriculararteryApexPage44trioventricularrooven

leftg(iveinsThe

Heart:ChambersAterft

ghtV

tricle

ig

ntricleehtenLeftAtrRiJtherightsideofthe

systemdeals

withdeoxygenatedblood.BodyOur

circulatory

system

is

a

double

circulatory

system.This

means

it

has

two

parts

parts.the

left

side

ofthe

systemdeals

withoxygenatedblood.cellsLungsCirculation□

Coronarycirculation—the

circulation

ofblood

within

theheart.Pulmonarycirculation-theflowof

blood

betweentheheartand

lungs.□

Systemiccirculation—theflow

of

bloodbetween

the

heartandthecells

ofthebody.High

bbod

presswre

in

ventrideslow

blood

pressure

in'

atrioSystemic

capiloriesThe

Heart:ValvesBicuspid(mitral)Tricuspid(AV)Fight

afrikamPulmonaryAorticTricuspid

vave(SL)Fight

wenfricieLaft

atriurnAarfic

vaveMicraf

waveLeft

ventriclebloodfromthe

lungsThe

heart

beat

beginswhentheheartmuscles

relaxand

blood

flows

intotheatria.How

doesSTEP

ONEblood

fromthe

bodythe

Heart

work?Theatriathencontract

andthevalvesopentoallow

bloodinto

the

ventricles.Howdoesthe

Heart

work?STEP

TWOThevalvesclosetostop

bloodflowingbackwards.The

ventricles

contract

forcingthe

blood

to

leave

the

heart.At

the

same

time,the

atria

arerelaxing

and

once

again

filling

withblood.STEP

THREEThe

cycle

then

repeats

itself.How

does

the

Heart

work?FillingofHeart

Chambers

-

theCardiac

CycleLeft

atriumRightatriumLeftventricleRightventricleVentricular②i

u

tyosl

lee)todialarinctriaentr(aVCopyright

◎

2003Pearson

Education,Inc.publishing

as

Benjamin

Cummings(Ventricularfilling)mid-to-late

diastole③EarlydiastolelsovolumetriccontractionphaseVentricularejection

phaselsovolumetric

relaxationAtrialcontractionfillingThe

Heart:CardiacOutput·Cardiac

output

(CO)

total

vent

blood/min·Amountof

blood

pumped

by

each

side

oftheheartinone

minute●

]·Strokevolume·Volumeofblood

pumped

byeachventricle

inonecontractionCopyright2003PearsonEducation,Inc.publishingasBenjaminCummingsVO[SCThe

Pulmonic

and

Aortican

a

da

i

rcedinto

the

arteriesfongis

beingre

openbloolvesS2-

What

is

it

?The

sounds

are

because

ofthe

closing

of

the

Pulmonic(

o

cf

th

a

milunarselvesevortivesuvalcanlod

i

g

f

t

e

icuspid

andb?hitoisnatclosS1-Wh

fi

pAidV

l

).(closuresseevlvvvestcotrtricuspla

vave

bicuspld

(mltralHeart

Soundsaortic

valvevalveAtriafill

withbloodWentriclesfill

withblood2004The

SAnode,or

pacemaker,initiatestheheartbeatand

causes

the

atria

tocontractonaverage

every

0.85seconds.Copyignte

TheMeGaHllComperies,ePamiThe.AVinodaconveysthe

stimulusandinitiatescontractionoftheventricles.'ConductiveSystemAction

potential-electricalimpulse

causingthe

contraction

ofheartmusclecellsPurkinjefibersa.branches

ofatrioventricularbundleThesignalfortheventriclestocontracttravelsfromtheAVnodethroughtheSAnode.AVnodebundleto

the

smalleratrioventricularPurkinjefibers.■

ei

tr

dgi

of

i

e

huering

aThe

P

wave

occurs

justclminyurcacacocarmythangramearcaosc)lGe(ECAnElectrocardiogramprior

to

atrial

contraction;

t

c

ursularoccntrilexepprior

to

vQRS

comjusthecontraction;and

the

Twave

occurs

when

theventricles

are

recoveringthe

electrical

changesfrom

contraction.CopyishtoTheWeGisAHilCmpaniess,lhc.Ferissionregiredfoseprodctonardisplar.Loose-

ctive(b)

CapillaryCopyright

◎

2003PearsonEducation,Inc.publishingasBenjaminCummingstissueconneTheVascularSystemTEundicoatheli

tmerna·Loose

connective

tissueInternalelasticlaminaTunica

mediaExternalelasticlaminaTunicaexternaVenuleCapillary

networkLumen

ArteryLumen

VeinEndotheliumArterioleValve。

s

ayers●

·Endothelium·Tunic

externa·Mostlyfibrous)lunichreeLumen-ValveEndotheliumof.tunicainternaCo

an

sueTunica

mediaTunicaexterna·dtiselasticnectiveBloodVessels:AnatomyTunic

media·Smooth

muscleTunic

intimaconnectivetissuecollagenousfibers)Gopyrignt@The

McGraw-HillGompanies.Inc.Permissionrequiredlorreproducionor

display.ArteryVeinABSuperiorvenacava

odeAtrioventricular

nodeRightatriumBundlebranchesPurkinjefibersakelpaceminoatriaConductiveSystemFigure

11.5Copyright

◎

2003Pearson

Education,Inc.publishing

as

Benjamin

CummingsAtrioventricular

of

His)PurkinjefibersInterventricularseptumleenddlun(BbuLeftatrium■

Tunicaexterna□

Outermost

layer□

elastin

and

collagen□Strengthens,Anchors■

Tunicamedia□CircularSmooth

Muscle□Vaso-constriction/dilationm

Tunica

intima□

Innermost

layer□

Endothelium□

Minimize

frictionulmen□

Middle

layerHealthy

ArteryHealthyVeinC#Rt*FharsCxxm

P6gnDastim

FibimElastin

Fe-kmDirection

ofblood

flowPressure

-closingvalveTowardthe

heanValve(open)Cusp

·of

valvePressureopeningvalve-Contracted

skeletalmuscleValve

closedValve(closed)VeinArteries(aa.)Veins(vv.)Directionof

flowBlood

Away

fromHeartBlood

to

HeartPressureHigherLowerWallsTHICKER:Tunicamedia

thicker

thantunica

externaTHINNER:Tunicaexterna

thickerthan

tunica

mediaLumenSmallerLargerValvesNo

valvesValvesArtery/Vein

differences

(归纳：dtwlv)Externalcarotida:—Internalcarotida.一CommoncarotidaBrachiocephalica—Axillary

a-Intercostal

aSuprarenala:Brachial

a.

Radial

a.RenalaCommon

iliaca.Uinara=External

iliaca:DeepfemoralaPopliteala:Anteriortibiala.Peroneal

a.Dorsalis

pedisaVertebrala.-Subclaviana.AortaCoronarya.Celiac

a.Superiormesenterica.

Lumbara.Inferiormesenterica.Gonadala.Internal

iliaca.~Femorala.Posteriortibiala.Superficia

atp

rimght

r

-Hi

.Inc.Parmission

required

for

reproduction

ar

displayaawporaTheMcDeep

brachial

aAnteriorfacial

v.Internal

jugular

v.Rightbrachiocephalicv

Axillaryv—Cephalicv-Brachialv:Basilicv—Median

cubital

v

—Radial

v-Renal

v.一UInar

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iliacv:Externaliliac

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—Azygosv.-Hepatic

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lumbarv.

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iliacv.

Cepyright

TheMcGraw-HillCampanies.Inc.Pemissionrequired

farreproduction

or

digplaySuperficialtemporalv.Posteriortibialv,—Smallsaphenousv-

Anteriortibialv-Greatsaphenousv.Jugular

SubclavianSuperiorvena

cavaSee

head

diagramfor

more

detail

aboutthe

aortic

arch

vessels.ThoracicAbdo

minalarteryof

thePularteryInferiorvenaCarotidArchPulmonary

veinvein

veinaortaaortamonaryaortacavaCoronaryarterycirculationCopynight

@The

McGraw-Hill

Gompanies,Ino.Permissian

required

for

repioductian

or

displaysuperiorvenacavaright

cardiacveinrightcoronary

arteryleftcardiac

veinleftarteryinferiorvenacoronarycavaPulse·Pulse

—pressure

waveof

blood·

Monitored

at“pressurepoints”wherepulse

iseasilypalpatedFemoral

arteryPoplitealarteryPosterior

tibial

arteryDorsalis

pedis

arteryFacial

arteryCarotidarteryBrachialarteryRadialarteryTemporalarteryMeasuringArterial

Blood

Pressure(b)(c)(d)Pressurein

cuffabove

120;

nosounds

audible120Blood

pressure

120systolic

bed

ured)asolicestmiato0Pressurein

cuffbelow

70;nosoundsaudiblePressurein

cuffbelow

120,but

above

70Rubber

cuffinflatedwith

airBrachial

artery(a)Soundsaudible

instethoscopeBrachial

artery

closed1

山

山12070CardiovascularDiseasesm

Cardiovascular

diseases

include

thosethat

affect

the

heart

and

those

that

affectm

The

heart

and

bloodvessels

may

beprimarily

attacked

by

these

diseases

orthey

may

be

secondarily

affected

as

aconsequence

of

another

disease.the

peripheral

vascularsystem.Risk

Factorsfor

Disease(sdosp)■

Smoking■Diabe